Multicenter investigation of the role of transjugular intrahepatic portosystemic shunt in management of portal hypertension

Douglas M. Coldwell, Ernest J. Ring, Chet R. Rees, Gerald Zemel, Michael D. Darcy, Ziv J. Haskal, Michael A. McKusick, Alan J. Greenfield

Research output: Contribution to journalArticle

119 Scopus citations

Abstract

PURPOSE: To determine the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) placement, a prospective multicenter trial was undertaken. MATERIALS AND METHODS: In eight institutions, 96 patients underwent TIPS placement after fared sclerotherapy (Child-Pugh class A [n = 24], class B [n = 38], and class C [n = 34]), with follow-up for 6 months (with ultrasonography and angiography and clinical and laboratory studies). RESULTS: TIPS placement was successful in all patients (mean initial portosystemic pressure gradient, 22.8 mm Hg + 6.7 [standard deviation]; mean decrease after placement, 12.8 mm Hg + 5.2), with variceal embolization in 25 patients. Complications included liver capsule puncture (n = 12), hepatic artery puncture (n = 3), main portal vein puncture (n = 1), and increased encephalopathy (n = 28). The 30-day mortality rate was 0% for patients with Child class A disease, 18% for class B, and 40% for class C. At 6 months, primary patency was 88% and assisted patency was 94%. CONCLUSION: The risk associated with TIPS placement is reasonable, and it is an effective procedure for the treatment of portal hypertension.

Original languageEnglish (US)
Pages (from-to)335-340
Number of pages6
JournalRadiology
Volume196
Issue number2
DOIs
StatePublished - Aug 1995

Keywords

  • Hypertension, portal
  • Liver, cirrhosis
  • Liver, interventional procedure
  • Shunts, portosystemic

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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    Coldwell, D. M., Ring, E. J., Rees, C. R., Zemel, G., Darcy, M. D., Haskal, Z. J., McKusick, M. A., & Greenfield, A. J. (1995). Multicenter investigation of the role of transjugular intrahepatic portosystemic shunt in management of portal hypertension. Radiology, 196(2), 335-340. https://doi.org/10.1148/radiology.196.2.7617842